RT Journal Article
SR Electronic
T1 Expiratory muscle activity and nasal expiratory pressure during reverse sniff
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3519
VO 40
IS Suppl 56
A1 Tsuyoshi Ichikawa
A1 Masanori Yokoba
A1 Naohito Ishii
A1 Akira Takakura
A1 Atsuhiko Matsunaga
A1 Masahiko Kimura
A1 Tadashi Abe
A1 Noriyuki Masuda
A1 Paul Easton
A1 Masato Katagiri
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P3519.abstract
AB The evaluation of expiratory muscle strength is of clinical importance in patients with neuromuscular respiratory disease. Maximal expiratory pressure (MEP) has achieved wide acceptance as a simple non-invasive measurement of expiratory muscle strength. However, MEP measurement is difficult for neuromuscular disease patients. In this study, we measured expiratory muscle activity during reverse sniff, a maneuver akin to “blowing your nose”, and we analyzed the relationship between expiratory muscle activity and reverse sniff nasal expiratory pressure (RSNEP).In 5 healthy subjects, mean age 21.2 yrs, weight 69.2 kg, height 176.6 cm, we inserted fine wire electrodes into transversus abdominis muscle (TA) using high-resolution ultrasound. RSNEP was measured through a catheter that occluded one nostril, while the contralateral nostril remained open. Subjects performed short, sharp, maximum and variable intensity of reverse sniff, beginning from FRC while standing. TA EMG activity was expressed as percent of maximum EMG (%EMGmax) throughout respiratory and non-respiratory maneuvers.Mean MEP was 80.8±0.6 cmH2O. Mean maximum RSNEP was 34.9±18.7 cmH2O, and mean TA EMG activity at maximum RSNEP was 73.9±23.6 %EMGmax. TA EMG activity increased with stepwise increments in RSNEP. In every subject, the linear relationship between RSNEP and TA EMG activity was significant (r = 0.56-0.98, p<0.05).We conclude that RSNEP corresponds to the activity of the expiratory muscle transversus abdominis, and that this simple maneuver may be useful for assessment of expiratory muscle strength.This study was approved by Kitasato university human ethics committee. This work was supported by MEXT of Japan KAKENHI (2350061).